OBSOLETE - THIS FORM IS NOW ON WWW.WOMENAGENTS OF CHANGE.ORG

REGISTRATION - AGENTS OF CHANGE (A.O.C) - AN ONLINE PROGRAM FOR WOMEN

- to participate in the 12 months of online and live learning, practice and reflection that will start October 23, 2017

- to undertake an action project to deliver on a change intention for myself, for a team or for a system I am able to influence

- to introduce 12 other women for free, by the Fall of 2018, to key frameworks, models, videos, insights or materials that have impacted you strongly during the course of the program. Note: it will be up to your creativity to determine how to accomplish this commitment - emails, in person dialogues, newsletter article, workshops, etc. All materials and knowledge gained in the A.O.C. is shareable with others with no fee due to the Agents of Change program.

Membership fee for the 12 months: $650 (an installment payment option is available with two payments of $350)

Note: The intention is to make this program accessible to women of all financial means. Therefore lets explore options if the fee timing is the obstacle. Email Dorian

For those who are concerned about timezones or technology requirements - a number of methods will be made available for you to select from to take full advantage of the development opportunity and to try new approaches to learning 'while virtual':

live online webinars on Zoom - planned for every three weeks starting October 23, 2017. One webinar videocall will be offered at 9am US Pacific and a second one will be offered at 6pm US Pacific.

recordings of the webinars will be available within 48 hours following a live webinar if you cannot attend or want to review some of the content

supporting documents and materials will be sent out to deepen knowledge in particular areas of focus

small group breakout discussions will be organized depending on interest and location and timezone constraints

peer action project learning trios will be set up to encourage peer-to-peer support and challenge

recommended articles, videos, audio clips and books will be provided

a password-protected website for W.A.C. participants with access to supporting materials and recordings of the webinars

an Agents of Change closed Facebook Group will be our primary place for online asynchronous reflection, connection with current participants and alumnae of the program, and the sharing of ideas and resources in between webinars

ad-hoc individual and group coaching calls will be set up to support each participant in her intentions

To complete Step 1 of registering for this program, please fill out the following information. Upon submitting this information, you’ll be automatically taken to Step 2, the payment options.

Name *

Name

First Name

Last Name

Email Address *

Phone

Phone

if your phone number does not fit this form's structure, simply type it in the intention field. thank you

Country

(###)

###

####

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

WHAT INTENTION ARE YOU BRINGING INTO THE PROGRAM *

Please check to signal your commitment *

I commit to my own development, my action project and sharing elements of what I learn with 12 other women by the Fall of 2018

Payment Options *

I will make the one time $650 membership fee.

I will make two payments of $350 each. I understand that the second one will be invoiced to me in April of 2018.

I am a Founding Circle Alumna.

Thank you for Registering for Agents of Change!

See you October 23, 2017 for our first 2-hour webinar on Zoom. Please mark your calendars now for either 9am US Pacific or 6pm US Pacific on October 23, 2017 and download Zoom(free) onto your laptop to avoid technical challenges.

More information will be coming your way via email from dorian@dorianbaroni.com. Best, Dorian